HomeMy WebLinkAbout07100129 Application??o eqR Permit #:01
City of Carmel/Clay ToKwship
COMMERCIAL/lNSTITUTIONAL/MULTI-FAIIIILY UYIPAOYEMENT LOCATION PERMIT
APPLICATION (For New Structures, Additions, Remodels, Tenant Finishes, & Accessory Buildings)
BUILDER NAME: PHONE: FAX:
OF % - /- 17- t -I7Yl
RECORD: STREETADDRESS: CRY: STATE: ZIP:
'
-?33Cr rN Y(
) ,
BUILDER'S EMAIL ADDRESS: BEST METHOD OF CONTACT:
,SC9 Stu( CAAA-HOST t- o? taM i-2,1 Z' 4Y4--I lY
PROPERTY NAME.
L PHONE: LAX:
ER L a
3iz
Sir-1ys
:
OWN
STREETADDRES . CITY: STATE: ZIP'.
3 .D I 153- A r - -F-- T? Y`o3?
LOCATION ADDRESS OF CONS7RLIC ION: Sul-% ?,: (If APPL,:`J
??!/7
& PROJECT 3?15'O 131sT sTRE? T r I llv
INFO: Address of Sheli Building: (3f dfferentthan Ada:ess o Con5tru lion) U Lot 9 and Subdivision: (Y Applicable)
BUADING, PROJECT, OR TENANT NAME: ZONING: TAX MAP PARCEL #:
STATE COMMERCIAL SCOPE(S) OF G FDN C STR ARCH C MECH G PLUM SQUARE
FOOTAGE
DESIGN RELEASE it: RELEASE: o ELEC C SPKLR OTHER(S) : ,
WATER UTILITY SEWER UTILITY ESTIMATED COST OF CONSTRUCTION:
PROVIDER: PROVIDER: (ExCW?INGD VALUE) °c:
PLAN COMMISSION, BZA I BPW DOCKET NUMBERS; ANDfCR
i
A•
'S
II A
* I
? ~7
?`
COUNTY WELL AND/OR ): V
`
(
ppl
c
SEPTIC PERMIT # O
f
of Floors: Elevator or lift-.'¢ YES O NO BLDG. CONSTRUCTION TYPE:
V CUPANCY C EIFIC4 ON:
TYPE OF CONSTRUCTION: ?;.
COMMERCIAL
(Privately Owned. hospitals..
offices/centers arercdmmer
? INSTITil;ThDYYAL?'',\??, c
D POST &
TYPE OF IMPROVEMENT:
J
<.I j?)
`a
NEW STRUCTURE
ADDITION
? Ro M?S)
O Parch
Q Mc77anire or Deck
REMODEL
NEW TENANT FINISH
ACCESSORY BUILDING
DETACHED GARAGE
ATTACHED GARAGE
CELL TOWER (New)
CELL TOWER CO-LOCATE
DEMOLITION
y
LYG v R" C
I
? r
O
(ChVck all which
construction area)
E-) CRAWL SPACE ?
BEAM .-PIER ? BASEMENT {WALKCUT:_Y_N)
PROJECT INFORMATION:
Early Release Manufactured
Permit: Y N Trusses: _Y V N
Lot Split: _Y 7',!/- NN sump Pump: ?YXN
i
FLOOD ZONE AREA DESIGNATION(S) FOR THIS PROPERTY:
V- r x,:41 QA
PLUMBING CONTRACTOR:
i
Plumber's Indi na State License #:
?1l
Class I structure permies aze subject to the
I, the nndervgned, agree char ary constrx:ian, rec hr, ctioq enlargenea[, relxac
dds app!satioa •Nll ce?p':y with, andconform m, i ?Ec+?Tippf e ]
adop[ed underay[LoH}o LC. 36-7 e[seq, G[rera't blvGctT3ht a?
[o ::tc nrt fewer. l further cerdfy t it the cons¢uction will not be
cannecmd ea
issue by the Department of Com-miry Senic IEatmel, Indiana.
signawm of owner W AuthoriZe Agent Prink
of Indiana(See 575 IAC 12) regarding ,.pj a inn dme Ft urr s for heeinning and
alrererioa of e s¢ucture. s auy,home in the osc of lane. or s[rectures reaucated 3q
oral the •Zoniag Ordinance of Carmel Indiana- 1993- (Z-289; and mencimeras,
Airs a_menda:orythexm. I Farther cent y rho- only- kit^.hen, Each, and Elror drains are
t occupied until a Cerrifim? ofOcCUjaancy-or Sudsianual C.omplerion has been
G
1 /H d
[fate
OFFICE USE ONLY **********sKs*s*s:z*Qksz*ss?:ssx=:fi:+{fifi.fi...+`,--r__.
INSPECTIONS REQUIRED: L/7 Filing Fees: -
Upper Footing Lower Footing Under5lab )?Jd?Base Inspections:
Rough In Meter Base Final
D o?
Reviewed/APP ved: DePt. of Community Services (Date)
5,Pewft,j rmylL CGMMERC L
Fee Receivec by: